This Clinical Practice review covers deep-vein thrombosis (DVT) affecting the upper extremities. As usual, the author presents an example patient and uses this case to discuss the management based on current published evidence.

The patient presented is a middle-aged lady who presents with pain, heaviness and functional impairment in her left arm: she has a history of ovarian cancer treated with chemotherapy given via an implanted catheter. Based on this scenario, the author discusses the condition under the following headings.

• The clinical problem, noting that it accounts for about 10% of DVT cases and patients are more likely to be younger, leaner, and have cancer.

• Strategies and evidence, including

o evaluation
o management, including anticoagulation, thrombolysis, mechanical and surgical interventions, staged multi-disciplinary management, and prevention.

• Areas of uncertainty

• Guidelines, noting that there are relevant guidelines from the American College of Chest Physicians

• Conclusions and recommendations